Jan. 19, 2001 -- That temper tantrum your teenage athlete is throwing might not be caused by the frustration of too much schoolwork or the violence he sees daily in television and movies. He may not even be upset over losing a big game. The real culprit could be anabolic steroids, once associated primarily with full-fledged bodybuilders but now taken by many teenagers to improve their bodies or enhance their performance in sports.
The National Institute on Drug Abuse (NIDA) is so concerned about a dramatic rise in steroid use by middle and high school students that in 2000, the agency's director issued a Community Drug Alert Bulletin. Alan Leshner, PhD, said that not only was there a significant increase in usage in 1999 compared with 1998 figures, but also fewer 12th-graders even believed that the substances -- which are essentially synthetic male hormones -- presented possible life-threatening, long-term health risks.
According to the "NIDA 1999 Monitoring the Future" study, about half a million adolescents are using anabolic/androgenic steroids. Indeed, 2.7% of eighth-graders, 2.7% of 10th-graders, and 2.9% of 12th-graders admit that they have used the drugs at least once.
To understand the reasons youngsters take the drugs, you first need to understand their effects. And to deter them from using steroids, experts say that you also need to understand the damage they can cause.
"They are basically male hormones that will enhance performance. It's become almost impossible to succeed in professional athletics without them," says Patricia Chandler, MD, of the Family Practice and Community Medicine Department at University of Texas Southwestern Medical Center at Dallas. "But they have multiple, multiple negative side effects."
These negative effects include reduced sperm production, shrinking of testicles, impotence, baldness, and irreversible breast enlargement in boys, and decreased body fat and breast size, deepening of the voice, loss of scalp hair, excessive body hair growth, and clitoral enlargement in girls. Both sexes could be affected with increased acne and personality changes, including aggressive behavior.
Some of these problems are reversible if anabolic steroid use is halted, but other consequences could alter your child's life or even shorten it. This includes stunting of their growth, liver cancer and cysts, lowering of HDL (good cholesterol) and increased LDL (bad cholesterol), high blood pressure, and higher propensity for heart attacks and strokes -- even in their teens.
Experts say there is no denying that taking any of the 100 or more varieties of the drugs will increase muscle and decrease fat, thereby boosting athletic ability. And for many, the temptation is just too great.
"They take [steroids] because they have been told that they will increase their athletic prowess and to bulk up. Boys are very interested in this just like girls want to be thin," says Adrian Dobs, MD, a professor of medicine at Johns Hopkins University School of Medicine. "This is very sad because they have a distorted view of their body image."
Writing in the journal The Physician and Sportsmedicine, Perry Koziris, PhD, an exercise physiologist at the University of North Texas in Denton, says that, ironically, many of the young people abusing anabolic steroids are "otherwise health-conscious persons who use a mix of muscle-building drugs."
He recommends further research to investigate the psychological and physiological effects of abuse of the drugs, specifically on adolescents. In addition, Koziris suggests that physicians and other medical professionals need to screen more thoroughly for signs of anabolic steroid use and that communities need to create comprehensive substance abuse prevention programs.
Both Dobs and Chandler agree that education is key to curbing use of the drugs. But they know it won't be easy.
"The teenage athlete is really hard to talk to about long-term effects," says Chandler, indicating that they tend not to view their future health as a consideration. "It's best to talk with them about the short-term effects such as acne and getting caught with drug testing."
However, Dobs says that effective programs do exist and that positive role models can make a difference. She tells WebMD that Canada has lunched a prevention program that stresses a sense of fair play as a reason not to take anabolic steroids.
"We need to get to kids when they are very young and educate them about fair play and health concerns," Dobs says. She points out that it "means something" in the eyes of potential or current young users that many athletic organizations, such as the NFL and the NCAA, have outlawed use of the drugs.
Unfortunately, according to both Chandler and Dobs, effective testing for use of anabolic steroids is still lacking.